Background: Endothelial dysfunction is one of the earliest vascular manifestations in the pathogenesis of cardiovascular disease. Noninvasive, simple and inexpensive methods of endothelial function assessment are therefore needed.
Methods: Microvascular endothelial function was assessed in coronary artery disease (CAD) patients by flow mediated skin fluorescence (FMSF), based on measurements of NADH fluorescence intensity during brachial artery occlusion (ischemic response [IRmax]) and immediately after occlusion (hyperemic response [HRmax]). Read More
Background: Percutaneous atrial septal defect (ASD) closure is a routine procedure to prevent right ventricular failure, pulmonary hypertension, or paradoxical embolism. The latter is the typical reason for percutaneous patent foramen ovale (PFO) closure. Atrial enlargement represents a risk for developing atrial fibrillation (AF). Read More
Background: Coronary bifurcation treatment poses a therapeutic challenge. The aim of this study was to analyze pooled data of two randomized clinical trials, POLBOS I and POLBOS II, to compare 1-year follow-up results and identify possible prognostic factors.
Methods: In POLBOS trials dedicated bifurcation BiOSS® stents were compared with regular drug eluting stents (rDES) in patients with stable coronary artery disease (CAD) or non ST-segment elevation acute coronary syndrome (POLBOS I: paclitaxel eluting BiOSS® Expert vs. Read More
Background: The increasing number of patients (pts) with implantable cardioverter-defibrillators (ICD) contributes to BACKGROUND: : The increasing number of patients with implantable cardioverter-defibrillators (ICD) contributes to the rising number of patients qualifying for a transvenous lead extraction (TLE) due to infection, vascular or lead failure related indications. The purpose of this study was to perform a retrospective analysis of the occurrence of conductor externalization in TLE patients and to assess the success rate in theextraction of these leads.
Methods: TLE procedure was performed between 2012 and 2014 of 428 electrodes in 259 patients. Read More
Background: The aim of this study was to evaluate implantable loop recorders (ILRs) in an unselected cohort in order to determine diagnostic yield, time to pacemaker/implantable cardioverter defibrillator (ICD) implantation, predictors thereof, safety issues, and syncope management including usage of preceding diagnostic tools.
Methods: Patients who underwent ILR evaluation in any of three centers in Region Gävleborg, Sweden, between April 2007 and April 2013 were included and their medical records retrieved. Logistic regression was used to evaluate predictors of pacemaker/ICD outcome expressed as odds ratios (ORs) and Kaplan-Meier estimates for time-dependent analysis. Read More
Background: Today, the main challenge for researchers is to develop new technologies which may help to improve the diagnoses of cardiovascular disease (CVD), thereby reducing healthcare costs and improving the quality of life for patients. This study aims to show the utility of biomedical shirt-based electrocardiography (ECG) monitoring of patients with CVD in different clinical situations using the Nuubo® ECG (nECG) system.
Methods: An investigator-initiated, multicentre, prospective observational study was carried out in a cardiology (adult and paediatric) and cardiac rehabilitation wards . Read More
Background: Fractional flow reserve (FFR) assesses a functional impact of the atheroma on the myocardial ischemia, but it does not take into account the morphology of the lesion. Previous optical coherence tomography (OCT), intravascular ultrasound (IVUS) and near infrared spectroscopy (NIRS) studies presented their potential to detect vulnerable plaque, which is not possible by FFR assessment. With the following study, the intermediate lesions were assessed by FFR, OCT and combined NIRS-IVUS imaging to identify plaque vulnerability. Read More
Background: Postconditioning can affect the infarct size in acute myocardial infarction (AMI). However, few studies show an effect of different postconditioning cycles on AMI aged patients. This study sought to assess the effect of different postconditioning cycles on prognosis in aged patients with AMI who underwent primary percutaneous coronary intervention (PCI). Read More
Background: Mainly atherosclerosis develops in distal left main (LM) within bifurcation or trifurcation. The aim of this study was to analyze the strategy of distal LM stenosis treatment and associated clinical outcomes in a large hospital in Northern Poland.
Methods: The study population consisted of consecutive patients with stable coronary artery disease or acute coronary syndrome (ACS) and distal LM stenosis who were hospitalized between June 2012 and June 2013. Read More
Department of Oral Medicine and Periodontal Disease, Medical University of Warsaw, Poland.
Background: Conducted pilot study concerning mean platelet volume parameter among patients suffering from congestive heart failure and periodontal disease.
Methods: Examination of dynamic changes of platelet and periodontal markers in group of 50 patients before and an average of 6 months subsequent to professional periodontal treatment.
Results: Both platelet and periodontal parameters decreased after periodontal treatment, what is more, the decrease of mean platelet volume (MPV) value due to periodontal disease/mm improvement was shown to be statistically significant (p = 0. Read More
Background: Apart from stroke, atrial fibrillation (AF) is associated with higher mortality and heart failure (HF), in which risk stratification scheme is lacking. Therefore this investigation examined the prognostic value of echocardiographic predictors against CHA₂DS₂-VASc score in permanent non-valvular AF (NVAF).
Method: In 252 asymptomatic or mildly symptomatic consecutive patients with NVAF, comprehensive echocardiography was performed. Read More
Background: As transcatheter aortic valve replacement (TAVI) becomes more straightforward, a larger proportion of patients will be well enough to be discharged early. This study sought to characterise the clinical features that allowed patients to be discharged early after TAVI and to evaluate the safety of an early discharge policy.
Methods: All patients undergoing TAVI at the above cited centre from August 2007 to March 2015 were included in this study. Read More
Background: Although many studies have evaluated the relationships between sleep duration and cardiovascular (CV) events/risk factors, longitudinal associations with time-dependent sleep duration have not been adequately assessed.
Methods: A retrospective, longitudinal study was conducted involving individuals aged 20 years or older that received annual health check-ups at St. Luke's International Hospital from 2005 to 2010. Read More
Background: Patients with stable coronary artery disease (CAD) have a worse quality of life (QoL) in comparison to patients without stable CAD. Standardized questionnaires are used in evaluation of QoL. Hybrid coronary revascularization (HCR) is a recently-introduced, minimally invasive option for patients requiring revascularization for coronary lesions. Read More
Background: The use of mild therapeutic hypothermia (MTH) in patients after out-of-hospital cardiac arrest (OHCA) who are undergoing primary percutaneous coronary intervention (pPCI) can protect patients from thromboembolic complications. The aim of the study was to evaluate the adaptive mechanisms of the coagulation system in MTH-treated comatose OHCA survivors.
Methods: Twenty one comatose OHCA survivors with acute coronary syndrome undergoing immediate pPCI were treated with MTH. Read More
Ola Hammarsten, MD, PhD, Professor Senior Physician Conjoint Professor, Newcastle University, Australia Institution of Biochemistry Department of clinical chemistry and transfusion medicine Bruna straket 16 Sahlgrenska academy at the University of Gothenburg SE 413 45 Gothenburg Sweden Email: Phone Lab:+46-31-342 9941 Mobile: +46-733-200834 Fax:+46-31-82 84 58.
Background: The implementation of high-sensitivity cardiac troponin T (hs-cTnT) assays and a cutoff based on the 99th cTnT percentile in the evaluation of patients with suspected acute coronary syndrome has not been uniform due to uncertain effects on health benefits and utilization of limited resources.
Methods: Clinical and laboratory data from patients with chest pain or dyspnea at the emergency department (ED) were evaluated before (n = 20516) and after (n = 18485) the lowering of the hs-cTnT cutoff point from 40 ng/L to the 99th hs-cTnT percentile of 14 ng/L in February 2012. Myocardial infarction (MI) was diagnosed at the discretion of the attending clinicians responsible for the patient. Read More
Background: Despite the low early mortality of Fontan procedures, Fontan patients are prone to various cardiac and extra-cardiac complications in the long term. This may influence patient perception of their health and outcome. The aim of the study was to assess the relationship of multi-organ complications and physical efficiency with self-reported health-related quality of life (QOL) in adult Fontan patients. Read More
Background: The number of patients with implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy and defibrillator (CRT-D) is growing. This results in high workloads for centers performing standard controls (SC) of these systems. Medtronic CareLink Express (MCLE) is a solution enabling remote controls (RC) of implantable devices. Read More
Fractional flow reserve (FFR) is an evidence-based diagnostic tool of physiological significance of coronary artery stenosis in patients with stable coronary artery disease (CAD). Due to microvascular dysfunction in acute coronary syndrome (ACS), information obtained from FFR assessment could be less reliable and, thus, its clinical role remains controversial. Indeed, results of currently published studies are essentially discrepant. Read More
Background: Herein is sought to determine whether the occurrence of post-operative atrial fibrillation (POAF) increases the risk of late recurrence of atrial fibrillation (AF) in patients undergoing open heart surgery (OHS).
Methods: This study included 938 patients (56.7 ± 13. Read More
Background: This study investigated the correlation between renal microcirculation and coronary microcirculation in hypertensive patients.
Methods: Participants consisted of 231 consecutive candidates who were referred to the Second Affiliated Hospital of Wenzhou Medical University from March 2014 to May 2016 for elective coronary angiography due to suspected myocardial ischemia. All participants were evaluated for the index of microvascular resistance (IMR), coronary flow reserve (CFR), and fractional flow reserve (FFR) using a pressure wire. Read More
Background: Blood urea nitrogen (BUN) has been shown to be associated with adverse cardiovascular disease outcomes. The aim of the present study was to evaluate the prognostic role of BUN in patients with acute aortic dissection (AAD).
Hypothesis: BUN has correlation with in-hospital mortality of patients with AAD. Read More
Background: To identify differences between proximal and distal cell rewiring with subsequent kissing balloon inflation (KBI) in the presence of a link connected to a carina on the jailed side branch ostium (SBO).
Methods: Kaname stents were deployed in bifurcation models (n = 12) with subsequent KBI and were confirmed by optical coherence tomography. The jailing configuration and cell rewiring were completely controlled and classified as follows: FC-Dist, free carina (no links connected to a carina) and distal cell rewiring; CC-Prox, connected to a carina (the presence of a link connected to a central carina) and proximal cell rewiring; CC-Dist, connected to a carina and distal cell rewiring; and FarDist, far-distal cell rewiring. Read More
Background: The reliability of intrathoracic impedance monitoring for prediction of heart failure (HF) by implantable cardiac devices is controversial. Despite using additional device-based parameters described in the PARTNERS HF study, such as new onset of arrhythmias, abnormal autonomics, low biventricular pacing rate or patient activity level, the predictive power of device diagnostic algorithm is still in doubt. The objective of this study was to compare the device diagnostic algorithm described in the PARTNERS HF study to a newly developed algorithm applying refined diagnostic criteria. Read More
Background: Development of electroanatomical systems make it possible to perform ablations without the use of fluoroscopy. The aim of this study was to evaluate the efficacy and safety of cryoablation procedures without the use of fluoroscopy.
Methods: The study group consisted of 45 patients (14 female; age 36 ± 15 years) treated with cryoablation using the EnSite electroanatomical system: 10 with ventricular extrasystoly from the right ventricle, 6 with the arrhythmogenic site near the left coronary artery, 17 patients with Wolff-Parkinson-White syndrome (WPW), 2 patients with atrioventricular nodal reentrant tachycardia (AVNRT) type 2, 7 patients with AVNRT type 1, 3 patients with atrial tachycardia. Read More
Background: The preventive role of acute occurring of collateral circulation (AOCC) to infarct related artery (IRA) in patients presenting with acute ST-segment elevation myocardial infarction (STEMI) is well known. Therefore, we aimed to investigate whether there is an association between admission plasma 25-(OH) vitamin D (25(OH)D3) levels and grade of collateralization in patients with STEMI.
Methods: We prospectively included 369 STEMI patients within the first 12 h of symptoms onset. Read More
The aim of this review is to highlight the technical details and the scientific data on percutaneous coronary interventions (PCIs) in chronic total occlusion (CTO) performed by transradial approach (TRA). Transfemoral approach (TFA) is commonly regarded as the standard for CTO PCI, but there are a growing number of CTO recanalization procedures performed by TRA. We discuss the relevant technical details to approach a CTO by transradial access, especially the compatibility of various CTO recanalization techniques with specific guiding catheter sizes. Read More
Background: Growth differentiation factor-15 (GDF-15), a biomarker associated with remodeling, oxidative stress and inflammation, has been used to stratify heart failure (HF) patients. However, its prognostic value in Chinese HF patients is still unknown.
Methods: GDF-15 levels were examined on admission in 272 consecutive HF patients in Beijing Hospital (a Chinese tertiary medical center) by a commercial enzyme-linked immunosorbent assay. Read More
Background: This study aimed to investigate the value of left atrial (LA) strain and strain rate (S/SR) by transthoracic echocardiography (TTE) in predicting left atrial appendage (LAA) stasis, in order to find a way for LAA stasis screening which is easily performed in patients with nonvalvular atrial fibrillation (NVAF).
Methods: One hundred and thirty NVAF patients prepared for AF ablation were enrolled. TTE and transesophageal echocardiography (TEE) were performed in all patients. Read More
Background: Cardiopulmonary exercise testing (CPET) is the gold standard in the evaluation of patients with chronic heart failure (CHF). However, this test is relatively expensive, assessment of its results requires experience, and in Poland it is available only in tertiary health care centers. Many heart rate (HR) parameters taken during a standard electrocardiographic (ECG) exercise test also shows prognostic values. Read More
Three-dimensional (3D) printing has attracted a huge interest in recent years. Broadly speaking, it refers to the technology which converts a predesigned virtual model to a touchable object. In clinical medicine, it usually converts a series of two-dimensional medical images acquired through computed tomography, magnetic resonance imaging or 3D echocardiography into a physical model. Read More
Background: Coronary bifurcation lesions pose therapeutic problems during percutaneous coronary interventions. The aim of this study was to analyze the strategy of coronary bifurcation treatment and associated angiographic as well as clinical outcomes in a large hospital in Northern Poland.
Methods: Between January 2012 and January 2014 patients with stable coronary artery disease or non-ST-elevation acute coronary syndrome (NSTE-ACS) were treated with regular drug-eluting stents (rDES) or dedicated bifurcation stents (BiOSS Expert® or BiOSS LIM®). Read More
Background: Patients with supraventricular tachycardia (SVT) and patients with coronary artery disease (CAD) often present with similar symptoms (chest pain, shortness of breath), similar electrocardiographic changes and elevated high-sensitivity troponin (cTn). It is not clear whether troponin reflects critical CAD or is elevated due to other causes in patients presenting with SVT. The aim of this study was to assess the role of elevated troponin in patients presenting with SVT. Read More
Background: Obesity contributes to left ventricular diastolic dysfunction (LVDD) and may lead to diastolic heart failure. Weight loss (WL) after bariatric surgery (BS) may influence LV morphology and function. Using echocardiography, this study assessed the effect of WL on LV diastolic function (LVDF) and LV and left atrium (LA) morphology 6 months after BS in young women with morbid obesity. Read More
Background: The choice of optimal antithrombotic regimen after transcatheter aortic valve replacement (TAVR) remains a matter of debate. The objective of this study was to compare both efficacy and safety outcomes based on the type of antithrombotic therapy prescribed after TAVR METHODS: This is a retrospective analysis of 514 consecutive patients treated with either dual antiplatelet therapy (DAPT) (n = 315; 61.3%) or oral anticoagulation (OAC) plus clopidogrel (n = 199; 38. Read More
Estimation of right ventricular (RV) performance still remains technically challenging due to its anatomical and functional distinctiveness. The current guidelines for the echocardiographic quantification of RV function recommend using multiple indices to describe the RV in a thorough and comprehensive manner, such as RV index of myocardial performance, tricuspid annular plane systolic excursion, fractional area change, Doppler tissue imaging-derived tricuspid lateral annular systolic velocity (S'-wave), three-dimensional RV ejection fraction (3D RVEF), longitudinal strain (RVLS)/strain rate by speckle-tracking echocardiography (STE). Among these, the last one mentioned here is an innovative and a particularly promising tool that yields more precise information about complex regional and global RV mechanics. Read More
Background: Despite left ventricular (LV) dysfunction contributing to mortality in chronic heart failure (HF), the molecular mechanisms of LV failure continues to remain poorly understood and myocardial biomarkers have yet to be identified. The aim of this pilot study was to investigate specific transcriptome changes occurring in cardiac tissues of patients with HF compared to healthy condition patients to improve diagnosis and possible treatment of affected subjects.
Methods: Unlike other studies, only dilated cardiomyopathy (DCM) (n = 2) and restrictive cardiomyopathy (RCM) (n = 2) patients who did not report family history of the disease were selected with the aim of obtaining a homogeneous population for the study. Read More